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Ke J, Wei Y, Chen B. Application of Hemoperfusion in the Treatment of Acute Poisoning. Blood Purif 2023; 53:49-60. [PMID: 37918359 DOI: 10.1159/000532050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 06/29/2023] [Indexed: 11/04/2023]
Abstract
Rescue of acute poisoning is a race against time, and it is particularly important to remove toxic substances in time. Traditional methods include gastric lavage, promoting elimination, chelating agents, and other treatments. Hemoperfusion is a common blood purification technique. In the clinical practice of acute poisoning, hemoperfusion can directly remove toxic substances through its unique adsorption effect, showing its excellent efficacy. This paper reviews the experience of hemoperfusion in the treatment of various drug overdoses, pesticides, biological toxins, and industrial poisons, even drug addiction. It is hoped to provide a reference for clinicians in acute poisoning rescue.
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Affiliation(s)
- Jianting Ke
- Department of Nephrology, Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Yuting Wei
- Department of Nephrology, Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Binhuan Chen
- Department of Nephrology, Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
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2
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Yan Y, Chen R, Yang Z, Ma Y, Huang J, Luo L, Liu H, Xu J, Chen W, Ding Y, Kong D, Zhang Q, Yu H. Application of back propagation neural network model optimized by particle swarm algorithm in predicting the risk of hypertension. J Clin Hypertens (Greenwich) 2022; 24:1606-1617. [PMID: 36380516 PMCID: PMC9731601 DOI: 10.1111/jch.14597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 10/02/2022] [Accepted: 10/23/2022] [Indexed: 11/18/2022]
Abstract
The structure of a back propagation neural network was optimized by a particle swarm optimization (PSO) algorithm, and a back propagation neural network model based on a PSO algorithm was constructed. By comparison with a general back propagation neural network and logistic regression, the fitting performance and prediction performance of the PSO algorithm is discussed. Furthermore, based on the back propagation neural network optimized by the PSO algorithm, the risk factors related to hypertension were further explored through the mean influence value algorithm to construct a risk prediction model. In the evaluation of the fitting effect, the root mean square error and coefficient of determination of the back propagation neural network based on the PSO algorithm were 0.09 and 0.29, respectively. In the comparison of prediction performance, the accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve of the back propagation neural network based on PSO algorithm were 85.38%, 43.90%, 96.66%, and 0.86, respectively. The results showed that the backpropagation neural network optimized by PSO had the best fitting effect and prediction performance. Meanwhile, the mean impact value algorithm could screen out the risk factors related to hypertension and build a disease prediction model, which can provide clues for exploring the pathogenesis of hypertension and preventing hypertension.
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Affiliation(s)
- Yan Yan
- Department of Epidemiology and Medical StatisticsSchool of Public HealthGuangdong Medical UniversityDongguanGuangdongChina
| | - Rong Chen
- Department of Epidemiology and Medical StatisticsSchool of Public HealthGuangdong Medical UniversityDongguanGuangdongChina
| | - Zihua Yang
- Department of Epidemiology and Medical StatisticsSchool of Public HealthGuangdong Medical UniversityDongguanGuangdongChina
| | - Yong Ma
- Department of Epidemiology and Medical StatisticsSchool of Public HealthGuangdong Medical UniversityDongguanGuangdongChina
| | - Jialu Huang
- Department of Epidemiology and Medical StatisticsSchool of Public HealthGuangdong Medical UniversityDongguanGuangdongChina
| | - Ling Luo
- Department of Epidemiology and Medical StatisticsSchool of Public HealthGuangdong Medical UniversityDongguanGuangdongChina
| | - Hao Liu
- Department of Epidemiology and Medical StatisticsSchool of Public HealthGuangdong Medical UniversityDongguanGuangdongChina
| | - Jian Xu
- Department of Epidemiology and Medical StatisticsSchool of Public HealthGuangdong Medical UniversityDongguanGuangdongChina
| | - Weiying Chen
- Department of Epidemiology and Medical StatisticsSchool of Public HealthGuangdong Medical UniversityDongguanGuangdongChina
| | - Yuanlin Ding
- Department of Epidemiology and Medical StatisticsSchool of Public HealthGuangdong Medical UniversityDongguanGuangdongChina
| | - Danli Kong
- Department of Epidemiology and Medical StatisticsSchool of Public HealthGuangdong Medical UniversityDongguanGuangdongChina
| | - Qiaoli Zhang
- Preventive Medicine and HygienicsDongguan Center for Disease Control and PreventionDongguanGuangdongChina
| | - Haibing Yu
- The First Dongguan Affiliated HospitalGuangdong Medical UniversityDongguanGuangdongChina,Key Laboratory of Chronic Disease Prevention and Control and Health StatisticsSchool of Public Health, Guangdong Medical UniversityDongguanGuangdongChina
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Zhang S, Song S, Luo X, Liu J, Liu M, Li W, Cao T, Li N, Zeng C, Zhang B, Cai H. Prognostic value of liver and kidney function parameters and their correlation with the ratio of urine-to-plasma paraquat in patients with paraquat poisoning. Basic Clin Pharmacol Toxicol 2021; 128:822-830. [PMID: 33411948 DOI: 10.1111/bcpt.13555] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/23/2020] [Accepted: 01/04/2021] [Indexed: 12/12/2022]
Abstract
Acute paraquat poisoning resulting from multiple organ failure usually has a high mortality rate. Liver and kidney, as the key oranges of paraquat detoxification and elimination, their injuries may suppress toxin excretion and enhance the toxicity of paraquat in other organs and worsen the prognosis. Therefore, we intended to explore the prognostic value of liver and kidney function parameters, and further evaluate their correlation with a more stable index urine-to-plasma paraquat (urine paraquat concentrations/plasma paraquat concentrations) instead of considering paraquat concentrations in plasma or urine alone. The study included 33 patients with acute paraquat poisoning admitted to four centres in China from January 2018 to December 2019. Seventeen patients (10 male/7 female) survived, whereas 16 patients (7 male/9 female, 48.48%) died from paraquat poisoning. Alanine aminotransferase (ALT) and the blood urea nitrogen (BUN) represent liver and kidney function parameters, respectively. The ratio of urine-to-plasma paraquat is negatively correlated with ALT (r = -0.94, P = 0 .02) and BUN (r = -0.82, P = 0.03). For receiver operating characteristic curve (ROC) analysis, ALT, BUN and urine-to-plasma paraquat have an AUC over 0.80. The study shows that the functional indexes of liver and kidney, as well as the ratio of urine-to-plasma paraquat, could be considered for evaluating the extent of organ injury and excretion rate of paraquat.
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Affiliation(s)
- Shuangyang Zhang
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China.,Institute of Clinical Pharmacy, Central South University, Changsha, China
| | - Shuai Song
- Department of Pharmacy, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xuemei Luo
- Department of Pharmacy, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University of Medical School, Nanjing, China
| | - Jianfeng Liu
- Department of Pharmacy, The First Affiliated Hospital of Hunan University of Medicine, Huaihua, China
| | - Mouze Liu
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China.,Institute of Clinical Pharmacy, Central South University, Changsha, China
| | - Wenqun Li
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China.,Institute of Clinical Pharmacy, Central South University, Changsha, China
| | - Ting Cao
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China.,Institute of Clinical Pharmacy, Central South University, Changsha, China
| | - Nana Li
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China.,Institute of Clinical Pharmacy, Central South University, Changsha, China
| | - Cuirong Zeng
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China.,Institute of Clinical Pharmacy, Central South University, Changsha, China
| | - Bikui Zhang
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China.,Institute of Clinical Pharmacy, Central South University, Changsha, China
| | - Hualin Cai
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China.,Institute of Clinical Pharmacy, Central South University, Changsha, China
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Xu Y, Lou H, Chen J, Jiang B, Yang D, Hu Y, Ruan Z. Application of a Backpropagation Artificial Neural Network in Predicting Plasma Concentration and Pharmacokinetic Parameters of Oral Single‐Dose Rosuvastatin in Healthy Subjects. Clin Pharmacol Drug Dev 2020; 9:867-875. [PMID: 32452647 DOI: 10.1002/cpdd.809] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 04/06/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Yichao Xu
- Center of Clinical Pharmacology Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou Zhejiang China
| | - Honggang Lou
- Center of Clinical Pharmacology Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou Zhejiang China
| | - Jinliang Chen
- Center of Clinical Pharmacology Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou Zhejiang China
| | - Bo Jiang
- Center of Clinical Pharmacology Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou Zhejiang China
| | - Dandan Yang
- Center of Clinical Pharmacology Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou Zhejiang China
| | - Yin Hu
- Center of Clinical Pharmacology Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou Zhejiang China
| | - Zourong Ruan
- Center of Clinical Pharmacology Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou Zhejiang China
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Wen C, Lin F, Huang B, Zhang Z, Wang X, Ma J, Lin G, Chen H, Hu L. Metabolomics Analysis in Acute Paraquat Poisoning Patients Based on UPLC-Q-TOF-MS and Machine Learning Approach. Chem Res Toxicol 2019; 32:629-637. [PMID: 30807114 DOI: 10.1021/acs.chemrestox.8b00328] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Most paraquat (PQ) poisoned patients died from acute multiple organ failure (MOF) such as lung, kidney, and heart. However, the exact mechanism of intoxication is still unclear. In order to find out the initial toxic mechanism of PQ poisoning, a blood metabolomics study based on ultraperformance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS) and efficient machine learning approach was performed on 23 PQ poisoned patients and 29 healthy subjects. The initial PQ plasma concentrations of PQ poisoned patients were >1000 ng/mL, and the blood samples were collected at before first hemoperfusion (HP), after first HP, and after last HP. The results showed that PQ poisoned patients all differed from healthy subjects, whatever they were before or after first HP or after last HP. The efficient machine learning approaches selected key metabolites from three UPLC/Q-TOF-MS data sets which had the highest classification performance in terms of classification accuracy, Matthews Correlation Coefficients, sensitivity, and specificity, respectively. The mass identification revealed that the most important metabolite was adenosine, which sustained in low level, regardless of whether PQ poisoned patients received HP treatment. In conclusion, decreased adenosine was the most important metabolite in PQ poisoned patients. The metabolic disturbance caused by PQ poisoning cannot be improved by HP treatment even the PQ was cleared from the blood.
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Affiliation(s)
- Congcong Wen
- Laboratory Animal Center of Wenzhou Medical University , Wenzhou 325035 , China
| | | | - Binge Huang
- Laboratory Animal Center of Wenzhou Medical University , Wenzhou 325035 , China
| | - Zhiguang Zhang
- Laboratory Animal Center of Wenzhou Medical University , Wenzhou 325035 , China
| | - Xianqin Wang
- Laboratory Animal Center of Wenzhou Medical University , Wenzhou 325035 , China
| | - Jianshe Ma
- Laboratory Animal Center of Wenzhou Medical University , Wenzhou 325035 , China
| | | | - Huiling Chen
- College of Physics and Electronic Information Engineering , Wenzhou University , Wenzhou 325035 , China
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Sun L, Yan PB, Zhang Y, Wei LQ, Li GQ. Effect of activated charcoal hemoperfusion on renal function in patients with paraquat poisoning. Exp Ther Med 2018; 15:2688-2692. [PMID: 29456670 DOI: 10.3892/etm.2018.5712] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 06/06/2017] [Indexed: 01/04/2023] Open
Abstract
The present study retrospectively analyzed 19 patients diagnosed with paraquat (PQ) poisoning with the aim to investigate the effect of activated charcoal hemoperfusion on renal function and PQ elimination. The results indicated that 7 patients died and 12 survived. Non-oliguric renal failure occurred in all of the 7 patients who died. Among the 12 surviving patients, 10 had normal renal function and 2 developed non-oliguric renal failure. There was a linear correlation between plasma and urine paraquat concentration prior to and during activated charcoal hemoperfusion. The equation parameters together with the correlation coefficient on admission were as follows: Y=0.5820+1.7348X (R2=0.678; F=35.768; P<0.0001). The equation parameters together with the correlation coefficient were as follows during activated charcoal hemoperfusion: Y=0.6827+1.2649X (R2=0.626; F=50.308; P<0.0001). Therefore, it was concluded that in patients with normal renal function, the elimination kinetics of PQ by the kidneys were only associated with the plasma PQ concentration. Activated charcoal hemoperfusion had little effect on avoiding acute kidney injury in patients with severe PQ poisoning.
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Affiliation(s)
- Liang Sun
- Department of Respiratory and Critical Care Medicine of Pingjing Hospital, Affiliated Hospital of Logistics University of Chinese People's Armed Police Force, Tianjin 300162, P.R. China
| | - Peng-Bo Yan
- Department of Respiratory and Critical Care Medicine of Pingjing Hospital, Affiliated Hospital of Logistics University of Chinese People's Armed Police Force, Tianjin 300162, P.R. China
| | - Yin Zhang
- Department of Respiratory and Critical Care Medicine of Pingjing Hospital, Affiliated Hospital of Logistics University of Chinese People's Armed Police Force, Tianjin 300162, P.R. China
| | - Lu-Qing Wei
- Department of Respiratory and Critical Care Medicine of Pingjing Hospital, Affiliated Hospital of Logistics University of Chinese People's Armed Police Force, Tianjin 300162, P.R. China
| | - Guo-Qiang Li
- Department of Respiratory and Critical Care Medicine of Pingjing Hospital, Affiliated Hospital of Logistics University of Chinese People's Armed Police Force, Tianjin 300162, P.R. China
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Effects of hemoperfusion and continuous renal replacement therapy on patient survival following paraquat poisoning. PLoS One 2017; 12:e0181207. [PMID: 28704509 PMCID: PMC5509301 DOI: 10.1371/journal.pone.0181207] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 06/27/2017] [Indexed: 02/06/2023] Open
Abstract
Mortality in patients with paraquat (PQ) poisoning is related to plasma PQ levels. Concentrations lower than 5,000 ng/mL are considered critical but curable. This study assessed the effects of hemoperfusion (HP) and continuous renal replacement therapy (CRRT) on the survival of PQ-poisoned patients with plasma PQ levels below 5,000ng/mL. We analyzed the records of 164 patients with PQ poisoning who were treated at the First Affiliated Hospital of Wenzhou Medical University in China between January 2011 and May 2015. We divided these patients into six sub-groups based on baseline plasma PQ levels and treatment, compared their clinical characteristics, and analyzed their survival rates. Patient sub-groups did not differ in terms of age, sex, time between poisoning and hospital admission, or time to first gavage. Biochemical indicators improved over time in all sub-groups following treatment, and the combined HP and CRRT treatment yielded better results than HP or CRRT alone. Fatality rates in the three treatment sub-groups did not differ among patients with baseline plasma PQ levels of 50–1,000 ng/mL, but in patients with 1,000–5,000 ng/mL levels, the mortality rate was 59.2% (HP treatment group), 48% (CRRT treatment group), and 37.9% (combined treatment group). Mortality rates were higher 10–30 days after hospitalization than in the first 10 days after admission. In the early stages of PQ poisoning, CRRT is effective in reducing patient fatality rates, particularly when combined with HP. Our data could be useful in increasing survival in acute PQ poisoning patients.
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Hao G, Wang D, Sun Y, Yu J, Lin F, Cao H. Association of blood glucose and lipid levels with complete blood count indices to establish a regression model. Biomed Rep 2017; 6:339-345. [PMID: 28451397 DOI: 10.3892/br.2017.852] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 11/23/2016] [Indexed: 11/06/2022] Open
Abstract
Hyperglycemia and hyperlipidemia, which are usually diagnosed by analysis of blood glucose (GLU) and lipid levels, are two of the most common diseases in modern society. The purpose of the current study was to investigate the potential association between blood GLU and lipid levels with complete blood count (CBC) indices in overweight and healthy individuals and establish a regression model. There were 456 healthy and 421 overweight participants in the study. Data were collected on triglyceride (TG), total cholesterol (CHO), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), blood GLU and CBC. The distribution characteristics and differences between healthy and overweight subjects were analyzed. Subsequently, the associations between TG, CHO, HDL, LDL and GLU with CBC were analyzed using correlation analysis and multiple linear regression (MLR). Significant differences were identified between the healthy and overweight individuals in TG, CHO, HDL, LDL, GLU and in the majority of the CBC indices. The correlation analysis indicated that there were strong correlations between TG, LDL, HDL, CHO and GLU with CBC indices in the healthy and overweight subjects. The MLR demonstrated that the regression models of TG, LDL, HDL and CHO, but no GLU, were statistically significant in the two groups (P<0.001). The HDL regression model exhibited the best regression parameters; the multiple correlation coefficients (R) were 0.351 and 0.308 in the healthy and overweight subjects, respectively. In the overweight and healthy subjects, there were strong correlations between TG, LDL, HDL and CHO with CBC indices, with HDL being the most relevant to the CBC indices. The CBC demonstrated statistical significance in the diagnosis of hyperlipidemia.
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Affiliation(s)
- Guangshu Hao
- Central Laboratory, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Dan Wang
- Central Laboratory, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Yanni Sun
- Central Laboratory, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Jiong Yu
- The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Feiyan Lin
- Central Laboratory, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Hongcui Cao
- Central Laboratory, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China.,The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
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Chen H, Hu L, Li H, Hong G, Zhang T, Ma J, Lu Z. An Effective Machine Learning Approach for Prognosis of Paraquat Poisoning Patients Using Blood Routine Indexes. Basic Clin Pharmacol Toxicol 2016; 120:86-96. [PMID: 27390221 DOI: 10.1111/bcpt.12638] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 06/30/2016] [Indexed: 12/18/2022]
Abstract
The early identification of toxic paraquat (PQ) poisoning in patients is critical to ensure timely and accurate prognosis. Although plasma PQ concentration has been reported as a clinical indicator of PQ poisoning, it is not commonly applied in practice due to the inconvenient necessary instruments and operation. In this study, we explored the use of blood routine indexes to identify the degree of PQ toxicity and/or diagnose PQ poisoning in patients via machine learning approach. Specifically, we developed a method based on support vector machine combined with the feature selection technique to accurately predict PQ poisoning risk status, then tested the method on 79 (42 male and 37 female; 41 living and 38 deceased) patients. The detection method was rigorously evaluated against a real-world data set to determine its accuracy, sensitivity and specificity. Feature selection was also applied to identify the factors correlated with risk status, and the results showed that there are significant differences in blood routine indexes between dead and living PQ-poisoned individuals (p-value < 0.01). Feature selection also showed that the most important correlated indexes are white blood cell and neutrophils. In conclusion, the toxicity or prognosis of PQ poisoning can be preliminarily ascertained by blood routine testing without PQ concentration data, representing an additional tool and innovative approach to assess the prognosis of PQ poisoning.
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Affiliation(s)
- Huiling Chen
- College of Physics and Electronic Information Engineering, Wenzhou University, Wenzhou, China
| | - Lufeng Hu
- Department of Pharmacy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Huaizhong Li
- Department of Computing, Lishui University, Lishui, 323000, Zhejiang, P. R. China
| | - Guangliang Hong
- Department of Emergency, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Tao Zhang
- Department of Emergency, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Department of Intensive Care Unit, Lishui Central Hospital, Lishui, China
| | - Jianshe Ma
- Analytical and Testing Center, Wenzhou Medical University, Wenzhou, China
| | - Zhongqiu Lu
- Department of Emergency, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Sun L, Yan PB, Zhang YH, Wei LQ, Li GQ. Continuous plasma perfusion of dual cartridges in series: rationale and early clinical experience. J Artif Organs 2016; 19:378-382. [PMID: 27411710 DOI: 10.1007/s10047-016-0917-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 06/29/2016] [Indexed: 12/18/2022]
Abstract
To improve the efficiency of plasma perfusion on eliminating plasma paraquat (PQ), we designed continuous plasma perfusion of dual cartridges in series (CPPDCS) on Diapact Braun CRRT machine. The goals of this study were to evaluate the effective of CPPDCS on paraquat removal in patients with acute paraquat intoxication. Our results show that the PQ clearance rate of dual cartridges was significantly higher than that of single cartridge at 1st, 2nd, 3rd, and 4th plasma perfusion. Compared with single-cartridge plasma perfusion, CPPDCS significantly reduced the frequency of cartridge replacement, shorten the time of perfusion. These results indicate that CPPDCS is effective than plasma perfusion of single cartridge on PQ clearance rate and may provide an effective treatment for PQ poisoning.
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Affiliation(s)
- Liang Sun
- Department of Respiratory and Critical Care Medicine of Ping Jing Hospital, Affiliated Hospital of Logistic University of Chinese People's Armed Police Force, 220#, Cheng-Lin Road, Tianjin, 300162, China
| | - Peng-Bo Yan
- Department of Respiratory and Critical Care Medicine of Ping Jing Hospital, Affiliated Hospital of Logistic University of Chinese People's Armed Police Force, 220#, Cheng-Lin Road, Tianjin, 300162, China
| | - Yu-Hua Zhang
- Department of Respiratory and Critical Care Medicine of Ping Jing Hospital, Affiliated Hospital of Logistic University of Chinese People's Armed Police Force, 220#, Cheng-Lin Road, Tianjin, 300162, China
| | - Lu-Qing Wei
- Department of Respiratory and Critical Care Medicine of Ping Jing Hospital, Affiliated Hospital of Logistic University of Chinese People's Armed Police Force, 220#, Cheng-Lin Road, Tianjin, 300162, China
| | - Guo-Qiang Li
- Department of Respiratory and Critical Care Medicine of Ping Jing Hospital, Affiliated Hospital of Logistic University of Chinese People's Armed Police Force, 220#, Cheng-Lin Road, Tianjin, 300162, China.
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Hong G, Hu L, Tang Y, Zhang T, Kang X, Zhao G, Lu Z. Prognosis and survival analysis of paraquat poisoned patients based on improved HPLC-UV method. J Pharmacol Toxicol Methods 2016; 80:75-81. [PMID: 27216136 DOI: 10.1016/j.vascn.2016.05.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 04/29/2016] [Accepted: 05/18/2016] [Indexed: 02/08/2023]
Abstract
UNLABELLED Paraquat (PQ) has caused deaths of numerous people around the world. In order to assess the lethal plasma concentration, the patients who acquired acute PQ intoxication were analyzed by plasma concentration monitoring. The plasma PQ concentrations were determined by high performance liquid chromatography (HPLC) which used 5-bromopyrimidine as internal standard and trichloroacetic acid-methanol (1:9) as protein precipitant. The liver, kidney and coagulation function were determined by automatic biochemical analyzer. According to plasma PQ concentration, 90 patients were divided into four groups: trace PQ group (<50ng/mL), low PQ group (<1000ng/mL), medium PQ group (1000-5000ng/mL) and high PQ group (>5000ng/mL). The clinical data from the four groups was statistically analyzed. The results showed the developed HPLC methods exhibited a high degree of accuracy and good linearity within 50-25000ng/mL (R=0.9998). The Spearman's correlation analysis showed PQ concentration had a strong relationship to total bilirubin, direct bilirubin, aspartic transaminase, urea nitrogen, prothrombin time, prothrombin activity, and international normalized ratio (P<0.01). The cured or survival PQ poisoned patients among the trace PQ group, the low PQ group, the medium PQ group, and the high PQ group were 19/19 (100%), 19/21 (90.47%), 11/25 (44.0%), and 0/25 (0%) respectively. The mean hospital days were (10.37±8.04), (18.76±12.06), (16.76±14.44), and (4.04±5.41) days respectively. The Cox regression analysis indicated that plasma PQ concentration was highly related to prognosis (P<0.05). In conclusion, no patient presenting with a PQ concentration over 5000ng/mL survived. The plasma PQ level is related to liver, kidney and coagulation function, which can be used as an important clinical index to judge the prognosis of PQ poisoned patients. CHEMICAL COMPOUNDS Paraquat (PubChem CID: 15938), 5-bromopyrimidine (PubChem CID: 78344), acetonitrile (PubChem CID: 6342), sodium dihydrogen phosphate (PubChem CID: 23672064), sodium heptanesulfonate (PubChem CID: 23672332), methylprednisolone (PubChem CID: 6741), cyclophosphamide (PubChem CID: 2907).
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Affiliation(s)
- Guangliang Hong
- Department of Emergency, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Lufeng Hu
- Department of Pharmacy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Yahui Tang
- Department of Emergency, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Tao Zhang
- Department of Intensive Care Unit, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China
| | - Xiaowen Kang
- Department of Emergency, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Guangju Zhao
- Department of Emergency, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Zhongqiu Lu
- Department of Emergency, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
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Lin B, Lin G, Liu X, Ma J, Wang X, Lin F, Hu L. Application of back-propagation artificial neural network and curve estimation in pharmacokinetics of losartan in rabbit. Int J Clin Exp Med 2015; 8:22352-22358. [PMID: 26885213 PMCID: PMC4729999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 12/05/2015] [Indexed: 06/05/2023]
Abstract
In order to develop pharmacokinetic model, a well-known multilayer feed-forward algorithm back-propagation artificial neural networks (BP-ANN) was applied to the pharmacokinetics of losartan in rabbit. The plasma concentrations of losartan in twelve rabbits, which were divided into two groups and given losartan 2 mg/kg by intravenous (Iv) and intragastrical (Ig) administration, were determined by LC-MS. The BP-ANN model included one input layer, hidden layers, and one output layer was constructed and compared with curve estimation based on the time-concentration data of losartan. The results showed the BP-ANN model had high goodness of fit index and good coherence (R > 0.99) between forecasted concentration and measured concentration both in Iv and Ig administration. The residuals of each concentrations generated by BP-ANN model were all smaller than Curve estimation. The pharmacokinetic result showed there was no significant difference between measured and simulated pharmacokinetic parameters including AUC(0-t), AUC(0-∞), MRT(0-t), MRT(0-∞), T1/2 V and Cmax (P > 0.05). In conclusion, the BP-ANN model has remarkably accurate predictions ability, which better than Curve estimation, and can be used as a utility tool in pharmacokinetic experiment.
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Affiliation(s)
- Bin Lin
- Department of Cardiology, Wenzhou Central HospitalWenzhou 325000, China
| | - Gaotong Lin
- Department of Pharmacy, Taizhou Cancer HospitalZhejiang Province, China
| | - Xianyun Liu
- Department of Pharmacy, The First Affiliated Hospital, Wenzhou Medical UniversityChina
| | - Jianshe Ma
- Analytical and Testing Center; Department of Pharmacology, Wenzhou Medical UniversityWenzhou 325035, China
| | - Xianchuan Wang
- Analytical and Testing Center; Department of Pharmacology, Wenzhou Medical UniversityWenzhou 325035, China
| | - Feiyan Lin
- Department of Pharmacy, The First Affiliated Hospital, Wenzhou Medical UniversityChina
| | - Lufeng Hu
- Department of Pharmacy, The First Affiliated Hospital, Wenzhou Medical UniversityChina
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Bao S, Geng P, Wang S, Zhou Y, Hu L, Yang X. Pharmacokinetics in rats and tissue distribution in mouse of magnoflorine by ultra performance liquid chromatography-tandem mass spectrometry. Int J Clin Exp Med 2015; 8:20168-20177. [PMID: 26884929 PMCID: PMC4723774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 11/01/2015] [Indexed: 06/05/2023]
Abstract
Magnoflorine is one of the most widespread aporphine alkaloids. In this work, a sensitive and selective ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method for the determination of magnoflorine in rat plasma and mouse tissue have been developed and validated. After addition of nuciferine as an internal standard (IS), protein precipitation by acetonitrile-methanol (9:1, v/v) was used for samples treatment. Chromatographic separation was achieved on a UPLC BEH C18 column (2.1 mm×100 mm, 1.7 μm) with 0.1% formic acid and acetonitrile as the mobile phase with gradient elution. An electrospray ionization source was applied and operated in positive ion mode; multiple reactions monitoring (MRM) mode was used for quantification using target fragment ions m/z 342.8→298.2 for magnoflorine and m/z 296.0→265.1 for IS. Calibration plots were linear throughout the range 2-2000 ng/mL for magnoflorine in rat plasma and tissue. Mean recoveries of magnoflorine in rat plasma were better than 83.0%. RSD of intra-day and inter-day precision were both less than 9%. The accuracy of the method was between 95.5% and 107.5%. The method was successfully applied to pharmacokinetics and tissue distribution study of magnoflorine. The absolute bioavailability of magnoflorine was reported as 22.6%. The magnoflorine underwent a rapid and wide distribution to tissues; the level of magnoflorine in liver is highest, then followed by heart, spleen and lung. Based on tissue distribution data, a back-propagation artificial neural network (BP-ANN) method was developed and it could be used to predict the concentrations of magnoflorine in tissues.
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Affiliation(s)
- Shihui Bao
- The Second Affiliated Hospital & Yuying Children’s Hospital, Wenzhou Medical UniversityWenzhou 325000, China
| | - Peiwu Geng
- The Laboratory of Clinical Pharmacy, The People’s Hospital of LishuiLishui 323000, China
| | - Shuanghu Wang
- The Laboratory of Clinical Pharmacy, The People’s Hospital of LishuiLishui 323000, China
| | - Yunfang Zhou
- The Laboratory of Clinical Pharmacy, The People’s Hospital of LishuiLishui 323000, China
| | - Lufeng Hu
- The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325035, China
| | - Xuezhi Yang
- The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325035, China
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Wang X, Wang S, Ma J, Ye T, Lu M, Fan M, Deng M, Hu L, Gao Z. Pharmacokinetics in rats and tissue distribution in mouse of berberrubine by UPLC-MS/MS. J Pharm Biomed Anal 2015; 115:368-74. [DOI: 10.1016/j.jpba.2015.07.031] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 06/22/2015] [Accepted: 07/22/2015] [Indexed: 11/16/2022]
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15
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Xu Y, Bao S, Tian W, Wen C, Hu L, Lin C. Tissue distribution model and pharmacokinetics of nuciferine based on UPLC-MS/MS and BP-ANN. Int J Clin Exp Med 2015; 8:17612-17622. [PMID: 26770351 PMCID: PMC4694251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Accepted: 10/06/2015] [Indexed: 06/05/2023]
Abstract
Nuciferine has shown remarkable biological activities and been considered as a promising drug. In this study, a sensitive and selective ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed and validated for determination of nuciferine in tissue and plasma. An electrospray ionization source was applied and operated in positive ion mode; multiple reactions monitoring (MRM) mode was used for quantification using target fragment ions m/z 296.0→265.1 for nuciferine, and m/z 322.0→307.0 for berberrubine internal standard (IS). Based on the UPLC-MS/MS method, the tissue distribution profile of nuciferine in mice and plasma pharmacokinetics in rat were studied. The results showed nuciferine was absorbed through intestinal tract and distributed into tissues rapidly. The bioavailability of nuciferine was identified at 17.9%. It can across through blood brain barrier, the concentrations in liver and kidney are highest, then followed by spleen, lung heart and brain. Nuciferine is eliminated quickly in the tissues and plasma, the t1/2 within 5 hour. The concentrations in these tissues are correlated to each other, and can be predicted by a back-propagation artificial neural network model.
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Affiliation(s)
- Yanyan Xu
- Department of Pharmacy, Lishui Central HospitalLishui 323000, China
| | - Shihui Bao
- The Second Affiliated Hospital & Yuying Children’s Hospital, Wenzhou Medical UniversityWenzhou 325000, China
| | - Weiqiang Tian
- Department of Pharmacy, Lishui Central HospitalLishui 323000, China
| | - Congcong Wen
- Laboratory Animal Center, Wenzhou Medical UniversityWenzhou 325035, China
| | - Lufeng Hu
- Department of Pharmacy, The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000, China
| | - Chongliang Lin
- Department of Pharmacy, The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000, China
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